24 April 2024 : Case report
[In Press] Remarkable Recovery After Severe Gunshot Brain Injury: A Comprehensive Case Study of Functional Rehabilitation
Unusual clinical course, Management of emergency care
Christos Tsitsipanis12ABDEF, Ioanna Papadimitriou3BDEF, Ioannis Tsoukaras4ABDEF, Nikolaos Moustakis1DEF, Sofia Lazarioti1DEF, Athanasios K. Theofanopoulos1BDF, Georgia Kritikou5EF, Konstantinos Ntotsikas1DEF, Panagiotis Simos6ADEF, Emmanouil Kokkinakis7BDF, Dimitris Karabetsos 1ABE, Antonis Vakis2ADEFDOI: 10.12659/AJCR.941601
Am J Case Rep In Press; DOI: 10.12659/AJCR.941601
Available online: 2024-04-24, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Abstract
BACKGROUND
Penetrating traumatic brain injury (TBI) caused by gunshots is a rare type of TBI that leads to poor outcomes and high mortality rates. Conducting a formal neuropsychological evaluation concerning a patient’s neurologic status during the chronic recovery phase can be challenging. Furthermore, the clinical assessment of survivors of penetrating TBI has not been adequately documented in the available literature. Severe TBI in patients can provide valuable information about the functional significance of the damaged brain regions. This information can help inform our understanding of the brain’s intricate neural network.
CASE REPORT
We present a case of a 29-year-old right-handed man who sustained a left-hemisphere TBI after a gunshot, causing extensive diffuse damage to the left cerebral and cerebellar hemispheres, mainly sparing the right hemisphere. The patient survived. The patient experienced spastic right-sided hemiplegia, facial hemiparesis, left hemiparesis, and right hemianopsia. Additionally, he had severe global aphasia, which caused difficulty comprehending verbal commands and recognizing printed letters or words within his visual field. However, his spontaneous facial expressions indicating emotions were preserved. The patient received a thorough neuropsychological assessment to evaluate his functional progress following a severe TBI and is deemed to have had a favorable outcome.
CONCLUSIONS
Research on cognitive function recovery following loss of the right cerebral hemisphere typically focuses on pediatric populations undergoing elective surgery to treat severe neurological disorders. In this rare instance of a favorable outcome, we assessed the capacity of the fully developed right hemisphere to sustain cognitive and emotional abilities, such as language.
Keywords: Case Reports; Cerebrum; Head Injuries, Penetrating; Neurobehavioral Manifestations; Wounds, Gunshot
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